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dc.contributor.authorSaposnik, Gustavo-
dc.contributor.authorPerez-Sempere, Angel-
dc.contributor.authorPrefasi, Daniel-
dc.contributor.authorSelchen, Daniel-
dc.contributor.authorRuff, Christian-
dc.contributor.authorMaurino, Jorge-
dc.contributor.authorTobler, Philippe-
dc.contributor.otherDepartamentos de la UMH::Medicina Clínicaes_ES
dc.date.accessioned2024-01-22T17:44:22Z-
dc.date.available2024-01-22T17:44:22Z-
dc.date.created2017-03-
dc.identifier.citationFrontiers in Neurology Volume 8 - 2017es_ES
dc.identifier.issn1664-2295-
dc.identifier.urihttps://hdl.handle.net/11000/30553-
dc.description.abstractObjectives: Limited information is available on physician-related factors influencing therapeutic inertia (TI) in multiple sclerosis (MS). Our aim was to evaluate whether physicians’ risk preferences are associated with TI in MS care, by applying concepts from behavioral economics. Design: In this cross-sectional study, participants answered questions regarding the management of 20 MS case scenarios, completed 3 surveys, and 4 experimental paradigms based on behavioral economics. Surveys and experiments included standardized measures of aversion ambiguity in financial and health domains, physicians’ reactions to uncertainty in patient care, and questions related to risk preferences in different domains. The primary outcome was TI when physicians faced a need for escalating therapy based on clinical (new relapse) and magnetic resonance imaging activity while patients were on a disease-modifying agent. Results: Of 161 neurologists who were invited to participate in the project, 136 cooperated with the study (cooperation rate 84.5%) and 96 completed the survey (response rate: 60%). TI was present in 68.8% of participants. Similar results were observed for definitions of TI based on modified Rio or clinical progression. Aversion to ambiguity was associated with higher prevalence of TI (86.4% with high aversion to ambiguity vs. 63.5% with lower or no aversion to ambiguity; p = 0.042). In multivariate analyses, high aversion to ambiguity was the strongest predictor of TI (OR 7.39; 95%CI 1.40–38.9), followed by low tolerance to uncertainty (OR 3.47; 95%CI 1.18–10.2). Conclusion: TI is a common phenomenon affecting nearly 7 out of 10 physicians caring for MS patients. Higher prevalence of TI was associated with physician’s strong aversion to ambiguity and low tolerance of uncertainty.es_ES
dc.formatapplication/pdfes_ES
dc.format.extent8es_ES
dc.language.isoenges_ES
dc.publisherFrontiers Mediaes_ES
dc.rightsinfo:eu-repo/semantics/openAccesses_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectmultiple sclerosises_ES
dc.subjectdisease-modifying therapyes_ES
dc.subjectneuroeconomicses_ES
dc.subjectdecision-makinges_ES
dc.subjectrisk aversiones_ES
dc.subject.otherCDU::6 - Ciencias aplicadas::61 - Medicinaes_ES
dc.titleDecision-making in Multiple Sclerosis: The Role of Aversion to Ambiguity for Therapeutic Inertia among Neurologists (DIScUTIR MS)es_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.relation.publisherversionhttps://doi.org/10.3389/fneur.2017.00065es_ES
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